- Advancing a Culture of Clinical Nursing Research Through Collaborative Partnership Between Practice and Academia. [Journal Article]
- NANurs Adm Q 2018 Oct/Dec; 42(4):299-304
- Engaging in clinical inquiry is a natural foundation for a nurse's critical thinking strategy and application to practice. Transforming clinical inquiry into a formal research question designed to im…
Engaging in clinical inquiry is a natural foundation for a nurse's critical thinking strategy and application to practice. Transforming clinical inquiry into a formal research question designed to improve patient care and/or the practice environment can, however, sometimes seem overwhelming to clinical nurses. It may even be seen as out of scope for their daily practice. As a result, aligning the trifold mission of service, education, and research at an Academic Health Sciences Center can be challenging unless there exists a purposeful strategy to achieve this goal. Since the publication of the Institute of Medicine "Future of Nursing Report" in 2010, Emory Healthcare Nursing and the Emory University Nell Hodgson Woodruff School of Nursing (SON) have sought to advance the vision and mission of strengthening and sustaining a culture of clinical inquiry to advance nursing science through nurse-led research. This vision also aligns with the American Association of Colleges of Nursing to identify paths for achieving enhanced partnerships between academic nursing and academic health centers. This goal has been conceptually important since then. In the last 2 years, there has been a renewed and invigorated commitment between Emory Healthcare Nursing and the Emory School of Nursing to forge a path for improving and sustaining a rigorous culture of collaborative and interprofessional research. This article describes the journey of the "One Emory Nursing" initiative, which spans from bedside/chairside to bench and back again. This work is built on a foundation of clinical nurses engaged in leading research that is designed to transform care in partnership with SON.
- The Effects of the Transforming Care at the Bedside Program on Perceived Team Effectiveness and Patient Outcomes. [Journal Article]
- HCHealth Care Manag (Frederick) 2017 Jan/Mar; 36(1):10-20
- The objective of the study was to document the impact of Transforming Care at the Bedside (TCAB) program on health care team's effectiveness, patient safety, and patient experience. A pretest and pos…
The objective of the study was to document the impact of Transforming Care at the Bedside (TCAB) program on health care team's effectiveness, patient safety, and patient experience. A pretest and posttest (team effectiveness) and a time-series study design (patient experience and safety) were used. The intervention (the TCAB program) was implemented in 8 units in a multihospital academic health science center in Montreal, Quebec, Canada. The impact of TCAB interventions was measured using the Team Effectiveness (TCAB teams, n = 50), and Clostridium difficile-associated diarrhea and vancomycin-resistant Enterobacter rates (patient safety) and Hospital Consumer Assessment of Healthcare Providers and Systems (patient experience; n = 551 patients). The intervention was composed of 4 learning modules, each lasting 12 to 15 weeks of workshops held at the start of each module, combined with hands-on learning 1 day per week. Transforming Care at the Bedside teams also selected 1 key safety indicator to improve throughout the initiative. Pretest and posttest differences indicate improvement on the 5 team effectiveness subscales. Improvement in vancomycin-resistant Enterococcus rate was also detected. No significant improvement was detected for patient experience. These findings call to attention the need to support ongoing quality improvement competency development among frontline teams.
- Engaging Frontline Staff in Performance Improvement: The American Organization of Nurse Executives Implementation of Transforming Care at the Bedside Collaborative. [Journal Article]
- JCJt Comm J Qual Patient Saf 2016; 42(2):61-9
- CONCLUSIONS: Given the strong positive assessment of TCAB, evidence of substantial engagement of staff in the work, and the high volume of innovations tested, implemented, and sustained, TCAB appears to be a productive model for organizing and implementing a program of frontline-led improvement.
- The effect of a transforming care initiative on patient outcomes in acute surgical units: a time series study. [Journal Article]
- JAJ Adv Nurs 2015; 71(2):417-29
- CONCLUSIONS: These results demonstrate that implementing a transforming care initiative may have some influence on the quality and safety of patient care as measured by patient falls and pressure ulcers but findings varied. Further research is required to gain an understanding of the inconsistency of the impact of these initiatives across all clinical contexts.
- Shaping a unit's culture through effective nurse-led quality improvement. [Journal Article]
- MNMedsurg Nurs 2013 Jul-Aug; 22(4):229-36
- Staff on a 28-bed medical telemetry unit learned the steps of effective nurse-led quality improvement through their participation in the Transforming Care at the Bedside initiative. The resulting cul…
Staff on a 28-bed medical telemetry unit learned the steps of effective nurse-led quality improvement through their participation in the Transforming Care at the Bedside initiative. The resulting culture change that occurred within the unit is described.
- The effect of transforming care at the bedside initiative on healthcare teams' work environments. [Journal Article]
- WEWorldviews Evid Based Nurs 2014; 11(1):16-25
- CONCLUSIONS: TCAB is an intervention that allows healthcare teams to implement change to improve patients' and families' outcomes. Ongoing energy should focus on how to improve communication among all members of the team and ensure their support.
- Transforming Care at the Bedside (TCAB): enhancing direct care and value-added care. [Journal Article]
- JNJ Nurs Manag 2013; 21(4):668-78
- CONCLUSIONS: Evidence supported the value-added dimension of the Transforming Care at the Bedside process at the unit level.Nurses recognized the significance of their input into processes of change. Transformational leadership and frontline projects provide a vehicle for innovation through application of human capital.
- "Change can be good": unit perspectives on transforming care at the bedside. [Journal Article]
- NANurs Adm Q 2012 Jul-Sep; 36(3):203-9
- CONCLUSIONS: Stakeholders recognized that "Change can be good!" Reflection and strategic evaluation strengthen planning for sustainability supporting staff engagement and transformational leadership in an academic health science setting.
- Do lean practices lead to more time at the bedside? [Review]
- JHJ Healthc Qual 2013 Mar-Apr; 35(2):7-14
- The aim of this review is to evaluate the application of value-added processes in healthcare, with an emphasis on their effects on bedside nursing. Literature relevant to Lean methodology and inpatie…
The aim of this review is to evaluate the application of value-added processes in healthcare, with an emphasis on their effects on bedside nursing. Literature relevant to Lean methodology and inpatient care was reviewed, excluding all research related to other service lines (i.e., surgical services, emergency services, laboratory, radiology, etc.). Increased value is also an important tenet of transforming care at the bedside (TCAB), an initiative launched by the Institute for Healthcare Improvement (IHI) and the Robert Wood Johnson Foundation (RWJF). Therefore, articles concerning TCAB were also included in this review. A systematic study of the literature revealed varied applications of Lean principles in practice, ranging from the implementation of a single tool, to full organizational restructuring. All articles reviewed reported positive results, although the majority lacked strong supporting evidence for claims of improvement. Even though there is some indication that the application of Lean principles to nursing processes is successful in improving specific outcomes, the authors cannot conclude that the implementation of Lean methodology or TCAB greatly influences direct patient care, or increases time spent at the bedside.
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- Vitality and teamwork. [Journal Article]
- AJAm J Nurs 2009; 109(8):70-1
- This is the 12th and final article in a series from Massachusetts General Hospital in Boston describing one general medical unit's experiences with Transforming Care at the Bedside (TCAB). An initiat…
This is the 12th and final article in a series from Massachusetts General Hospital in Boston describing one general medical unit's experiences with Transforming Care at the Bedside (TCAB). An initiative begun by the Robert Wood Johnson Foundation (RWJF) and the Institute for Healthcare Improvement, TCAB was developed as a way to improve care on medical-surgical units, patients' and family members' experience of care, and teamwork among care team members and to increase nurse satisfaction and retention. The TCAB philosophy engages all care leaders, but empowers bedside nurses to generate ideas and solutions for change. Mass General is one of 68 hospitals participating in a two-year TCAB initiative led by the American Organization of Nurse Executives and funded with a grant from the RWJF. For more information on TCAB, go to www.rwjf.org/pr/product.jsp?id=31512.